Surgical Invasion Evoking Nociception and Postoperative Complications

Abstract

Surgical invasion induces nociceptive stimuli, in which signals ascend from the spinal cord to the cerebral cortex, evoking nociception. It simultaneously causes autonomic responses and body movement. Surgical invasion also causes inflammatory responses and tissue damage during and after surgery, increasing C-reactive protein（CRP）levels in blood. Early increases in postoperative CRP levels are associated with severe postoperative complications. On the other hand, general anesthesia suppresses nociception. Nociception monitoring under general anesthesia estimates a quantified balance between nociception and anti-nociception by using variables evoked by autonomic responses or in the electroencephalogram. A nociception monitoring value during surgery has the potential to be an objective indicator of surgical invasion.